Prevalence of streptocochemical hemolytic beta from group a in asympletic children

Abstract

Upper airway infections are one of the most common causes of medical appointment in clinical practice mainly faced by pediatric population.1 According to a study conducted by Morais et al.2 the incidence of respiratory tract infections due to β-hemolytic streptococcus can be more than 18times higher in children attending some day care center or environments where they are close to others sharing belongings. However, individuals of all ages are susceptible to propagation of this microorganism under conditions of overcrowding, because the interpersonal dissemination of these bacteria occurs through aerosolized microdroplets and/or by direct contact, mainly in environments where there are clusters of people. Among the diseases that affect the upper airways, acute pharyngitis (AP) is one of the most frequent in children. Although most of the AP is of viral origin, Group a Streptococcus Beta-hemolytic (EBHGA) presents as a significant bacterial etiological agent diagnosed in about 15-30% of acute pharyngitis.3 EBHGA or Streptococcus pyogenic is grampositive aerobic bacteria that causes a variety of infectious syndromes4 and is considered of great clinical interest due to its high pathogen city, usually involving or pharynx and skin, as a consequence these bacteria may cause several inflammatory diseases. One of the main laboratorial characteristics this pathogen presents to be identified and classified is the ability to shatter completely red blood cells in 5% sheep blood culture, causing a transparency in the culture medium, which is called Beta-hemolytic.5 Streptococcus pyogenic is important when compared to groups B, C and G, not only because it is the main etiological agent of streptococcal pharyngitis,6 but also because it causes suppurate complications such as, cervical adenitis, peritonsillar abscess, retropharyngeal or cervical abscess.7 In addition, EBHGA is related to other diseases such as streptococcal toxic shock syndrome, necrotizing fasciitis, scarlet fever and skin infections.8 According to Areas et al.9 its main complications are acute rheumatic fever, rheumatic heart disease and acute streptococcal disease, with a higher incidence especially in developing countries. Therefore, the early diagnosis of this condition, followed by adequate antimicrobial treatment, is extremely important not just for the prevention of rheumatic fever (RF) and other pathologies, but also for the reduction of EBHGA transmission among patients.3 Living in restricted settings, such as day care centers and schools, can greatly influence the dissemination of these bacteria, placing the health of children and adolescents at risk,10 considering that children and teenagers or pharynx is very sensitive to EBHGA infections, especially among 5 And 15years of age.11 Besides that, they can carry pathogenic microorganisms without presenting symptoms, characterizing the asymptomatic carriers. The epidemiological profile of this pathogen shows the relevance of it’s diagnosed due to the existence of complications it may cause and their ease of transmission.2 Therefore, a precise etiological diagnosis contributes to avoid the abusive use of antibiotics and its consequences as the increase of bacterial resistance.12 This study aimed to determine the prevalence of Group A β-hemolytic streptococcus in or pharynx of asymptomatic children who attend a public school and also the sensitivity and resistance profile of these bacteria to main antibiotics tested.